Abstract:
:Causes of congestive heart failure include hypertension, coronary artery disease, alcohol abuse and valvular heart disease. Two-dimensional echocardiography with Doppler examination is excellent for identifying valvular heart disease. While noninvasive screening for coronary artery disease may seem cost-effective, the consequences of a missed diagnosis are such that coronary angiography should be strongly considered if there is any suggestion of ischemic heart disease. Medical management primarily consists of vasodilators, diuretics and inotropic agents. Vasodilator therapy may prolong the patient's life. Digoxin and diuretics improve symptoms and hemodynamic abnormalities. With advanced heart failure, adequate control of fluid retention and dyspnea may require diuretic doses associated with azotemia, and systolic blood pressure may have to be maintained at less than 100 mm Hg in spite of postural hypotension.
journal_name
Am Fam Physicianjournal_title
American family physicianauthors
Vine DLsubject
Has Abstractpub_date
1990-09-01 00:00:00pages
739-52issue
3eissn
0002-838Xissn
1532-0650journal_volume
42pub_type
杂志文章,评审abstract::Family physicians can treat most finger fractures and dislocations, but when necessary, prompt referral to an orthopedic or hand surgeon is important to maximize future function. Examination includes radiography (oblique, anteroposterior, and true lateral views) and physical examination to detect fractures. Dislocatio...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2006-03-01 00:00:00
abstract::Although amenorrhea may result from a number of different conditions, a systematic evaluation including a detailed history, physical examination, and laboratory assessment of selected serum hormone levels can usually identify the underlying cause. Primary amenorrhea, which by definition is failure to reach menarche, i...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2013-06-01 00:00:00
abstract::Pretibial myxedema is a localized dermopathy seen in patients with past or present hyperthyroidism. Massive intradermal deposition of mucin (acid mucopolysaccharide) produces the classic indurated nodules or plaques on the anterior lower legs. Most patients have elevated levels of LATS in their serum; however, this ap...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1985-05-01 00:00:00
abstract::Tick-borne diseases in the United States include Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever. It is important for family physicians to consider these illnesses when patients present with influenza-like symptoms. A petechial rash initially af...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2005-06-15 00:00:00
abstract::Preterm birth is a major cause of infant morbidity and mortality. Although studies have been complicated by problems of definition and methodology, certain strategies have the potential to reduce both the incidence and the impact of preterm birth. These strategies include accurate assessment of gestational age, educat...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-08-01 00:00:00
abstract::Patients with symptomatic lumbar disk disease may present with back pain, referred leg pain, radicular leg pain, sensory changes and leg weakness. Because neurologic deficits are commonly localized to the L5 or S1 nerve roots, evaluation of patients with such symptoms should focus on these dermatomes and muscle groups...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-04-01 00:00:00
abstract::Risk factors for pulmonary embolism include immobilization, trauma and surgery, particularly for hip fracture. Patients may present with acute respiratory symptoms, including tachypnea, tachycardia and rales. Chest radiographs and clinical and laboratory findings alone cannot provide a firm diagnosis. A completely nor...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract::Ginger (Zingiber officinale) is one of the more commonly used herbal supplements. Although often consumed for culinary purposes, it is taken by many patients to treat a variety of conditions. Ginger has been shown to be effective for pregnancy-induced and postoperative nausea and vomiting. There is less evidence to su...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2007-06-01 00:00:00
abstract::A biopsychosocial theory and approach to drug-seeking behavior suggests new questions for the family physician to ask his patient when psychotropic drugs are being considered. The theory and rational guidelines for prescribing allow the physician to make more appropriate decisions when faced with difficult situations....
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1979-01-01 00:00:00
abstract::Irritable bowel syndrome is the most common functional disorder of the gastrointestinal tract and is frequently treated by family physicians. Despite patients' worries about the symptoms of irritable bowel syndrome, it is a benign condition. The diagnosis should be made using standard criteria after red flags that may...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2002-11-15 00:00:00
abstract::A large number of drugs are introduced every year, and new interactions between medications are increasingly reported. Consequently, it is no longer practical for physicians to rely on memory alone to avoid potential drug interactions. Multiple drug regimens carry the risk of adverse interactions. Precipitant drugs mo...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-03-15 00:00:00
abstract::Serotonin syndrome is a potentially life-threatening complication of psychopharmacologic drug therapy. The syndrome is produced most often by the concurrent use of two or more drugs that increase brainstem serotonin activity and is often unrecognized because of the varied and nonspecific nature of its symptomatology. ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::Urine drug screening can enhance workplace safety, monitor medication compliance, and detect drug abuse. Ordering and interpreting these tests requires an understanding of testing modalities, detection times for specific drugs, and common explanations for false-positive and false-negative results. Employment screening...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2010-03-01 00:00:00
abstract::"White coat" or "office" hypertension is often defined as the transient rise or elevation of blood pressure that occurs in the medical setting. Patients with these elevated readings have normal ambulatory pressures as determined by individual home blood pressure measurements or continuous 24-hour blood pressure monito...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1995-07-01 00:00:00
abstract::Atrial fibrillation is the arrhythmia most commonly encountered in family practice. Serious complications can include congestive heart failure, myocardial infarction, and thromboembolism. Initial treatment is directed at controlling the ventricular rate, most often with a calcium channel blocker, a beta blocker, or di...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2002-07-15 00:00:00
abstract::Many patients in primary care present with ear pain (otalgia). When the ear is the source of the pain (primary otalgia), the ear examination is usually abnormal. When the ear is not the source of the pain (secondary otalgia), the ear examination is typically normal. The cause of primary otalgia is usually apparent on ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2008-03-01 00:00:00
abstract::Risk factors for stroke should be evaluated in patients who have had a transient ischemic attack. Blood pressure, lipid levels, and diabetes mellitus should be controlled. When applicable, smoking cessation and weight loss also are important. Angiotensin-converting enzyme inhibitor therapy may help prevent stroke. Asp...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2004-04-01 00:00:00
abstract::Rheumatoid arthritis is a connective tissue disorder of unknown etiology that can involve any synovial-lined joint in the body. The most frequently involved joints are the small joints of the hands and feet, the wrists, knees and elbows, and the glenohumeral and acromioclavicular joints. The radiographic hallmarks of ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::The prevalence of childhood obesity in the United States has risen dramatically in the past several decades. Although 25 to 30 percent of children are affected, this condition is underdiagnosed and undertreated. Hormonal and genetic factors are rarely the cause of childhood obesity; unnecessary diagnostic evaluations ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1999-02-15 00:00:00
abstract::Caring for the problem drinker in the perioperative period is a challenging task. If alcohol abuse is suspected, a careful assessment is indicated before surgery is performed. Both the CAGE and SMAST questionnaires are good screening tools for alcoholism. Preoperative evaluation of alcohol-dependent patients should in...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1995-12-01 00:00:00
abstract::Frequent school absenteeism has immediate and long-term negative effects on academic performance, social functioning, high school and college graduation rates, adult income, health, and life expectancy. Previous research focused on distinguishing between truancy and anxiety-driven school refusal, but current policy ha...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2018-12-15 00:00:00
abstract::Heel pain is a common presenting symptom in ambulatory clinics. There are many causes, but a mechanical etiology is most common. Location of pain can be a guide to the proper diagnosis. The most common diagnosis is plantar fasciitis, a condition that leads to medial plantar heel pain, especially with the first weight-...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2011-10-15 00:00:00
abstract::Myocardial perfusion imaging with thallium-201 has been used extensively for many years in the evaluation of ischemic heart disease. It is a valuable adjunct to exercise treadmill testing and is especially helpful in evaluating cardiac perfusion in patients who have abnormal resting electrocardiograms, who are unable ...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-11-01 00:00:00
abstract::More than 30% of U.S. adults report having experienced low back pain within the preceding three months. Although most low back pain is nonspecific and self-limiting, a subset of patients develop chronic low back pain, defined as persistent symptoms for longer than three months. Low back pain is categorized as nonspeci...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:2015-05-15 00:00:00
abstract::Substantial advances have been made in the management of inflammatory bowel disease. Mesalamine and olsalazine are new anti-inflammatory agents that may serve as alternatives to corticosteroids and sulfasalazine, which have been the mainstays of medical therapy. These new agents are available in oral, enema and suppos...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1993-03-01 00:00:00
abstract::The physician needs to know the signs, symptoms and recommended treatments of drug overdoses. Overdose of hallucinogens usually does not require drug therapy. Overdose of amphetamines ("uppers") may be complicated by the presence of PCP, a dissociative substance. It is important for the physician to be familiar with t...
journal_title:American family physician
pub_type: 杂志文章
doi:
更新日期:1986-03-01 00:00:00
abstract::Natural supplements are widely used in the United States and, while claims of their therapeutic effects abound, medical research does not always support their effectiveness. St. John's wort acts as a weak selective serotonin reuptake inhibitor with fewer side effects. S-Adenosylmethionine (SAMe) has enough of an antid...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2000-09-01 00:00:00
abstract::Although a rare entity, laryngeal tuberculosis must be a diagnostic consideration--along with laryngeal carcinoma--whenever patients present with prolonged hoarseness or painful dysphagia. This form of tuberculosis was once thought to be especially virulent and more infectious than other forms; however, severity was p...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:1992-09-01 00:00:00
abstract::The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk alcohol use receive treatment. T...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2016-03-15 00:00:00
abstract::Pregnant women commonly use over-the-counter medications. Although most over-the-counter drugs have an excellent safety profile, some have unproven safety or are known to adversely affect the fetus. The safety profile of some medications may change according to the gestational age of the fetus. Because an estimated 10...
journal_title:American family physician
pub_type: 杂志文章,评审
doi:
更新日期:2003-06-15 00:00:00